Cognitive rehabilitation for spatial neglect following stroke

Bowen, Audrey; Lincoln, Nadina B.; Dewey, Michael

doi:10.1002/14651858.cd003586

Cited by 72 publications

(88 citation statements)

References 27 publications

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“…Treatment options to date show limited efficiency (Bowen et al, 2013) despite being time-intense. They mostly aim to compensate (e.g., optokinetic stimulation or neck muscle vibration) or substitute functions (e.g., prism adaptation), and few aim to restitute functions (e.g., mental imagery).…”

Section: Introductionmentioning

confidence: 99%

Treatment of visuospatial neglect with biparietal tDCS and cognitive training: a single-case study

Brem¹,

Unterburger²,

Speight³

et al. 2014

Front. Syst. Neurosci.

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Symptoms of visuospatial neglect occur frequently after unilateral brain damage. Neglect hampers rehabilitation progress and is associated with reduced quality of life. However, existing treatment methods show limited efficacy. Transcranial direct current stimulation (tDCS) is a neuromodulatory technique, which can be used to increase or decrease brain excitability. Its combination with conventional neglect therapy may enhance treatment efficacy. A 72-year-old male with a subacute ischemic stroke of the right posterior cerebral artery suffering from visuospatial neglect, hemianopia, and hemiparesis was treated with biparietal tDCS and cognitive neglect therapy in a double-blind, sham-controlled single-case study. Four weeks of daily treatment sessions (5 days per week, 30 min) were started 26 days post-stroke. During week 1 and 4 the patient received conventional neglect therapy, during week 2, conventional neglect therapy was combined once with sham and once with real biparietal tDCS. Week 3 consisted of daily sessions of real biparietal tDCS (1 mA, 20 min) combined with neglect therapy. Outcome measures were assessed before, immediately after, as well as 1 week and 3 months after the end of treatment. They included subtests of the Test for Attentional Performance (TAP): covert attention (main outcome), alertness, visual field; the Neglect-Test (NET): line bisection, cancelation, copying; and activities of daily living (ADL). After real stimulation, covert attention allocation toward left-sided invalid stimuli was significantly improved, and line bisection and copying improved qualitatively as compared to sham stimulation. ADL were only improved at the 3-month follow-up. This single-case study demonstrates for the first time that combined application of tDCS and cognitive training may enhance training-induced improvements in measures of visuospatial neglect and is applicable in a clinical context.

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Section: Introductionmentioning

confidence: 99%

Treatment of visuospatial neglect with biparietal tDCS and cognitive training: a single-case study

Brem¹,

Unterburger²,

Speight³

et al. 2014

Front. Syst. Neurosci.

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show abstract

“…This leads to difficulties engaging in everyday tasks (Luauté et al, 2006; Bowen and Lincoln, 2008), which in turn reduces functional independence. Importantly, the presence of neglect is associated with worse rehabilitation outcome (Jehkonen et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Reducing Chronic Visuo-Spatial Neglect Following Right Hemisphere Stroke Through Instrument Playing

Bodak

Malhotra

Bernardi

et al. 2014

Front. Hum. Neurosci.

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Unilateral visuo-spatial neglect is a neuropsychological syndrome commonly resulting from right hemisphere stroke at the temporo-parietal junction of the infero-posterior parietal cortex. Neglect is characterized by reduced awareness of stimuli presented on patients’ contralesional side of space. Inspired by evidence of increased spatial exploration of patients’ left side achieved during keyboard scale-playing, the current study employed a music intervention that involved making sequential goal-directed actions in the neglected part of space, in order to determine whether this would bring about clinically significant improvement in chronic neglect. Two left neglect patients completed an intervention comprising four weekly 30-min music intervention sessions involving playing scales and familiar melodies on chime bars from right to left. Two cancellation tests [Mesulam shape, Behavioral Inattention Test (BIT) star], the neglect subtest from the computerized TAP (Test of Attentional Performance) battery, and the line bisection test were administered three times during a preliminary baseline phase, before and after the four intervention sessions during the intervention phase to investigate short-term effects, and 1 week after the last intervention session to investigate whether any changes in performance would persist. Both patients demonstrated significant short-term and longer-lasting improvements on the Mesulam shape cancellation test. One patient also showed longer-lasting effects on the BIT star cancellation test and scored in the normal range 1 week after the intervention. These findings provide preliminary evidence that active music-making with a horizontally aligned instrument may help neglect patients attend more to their affected side.

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“…As a result, a large number of rehabilitation programs, such as prism adaptation and vestibular stimulation, have focused on correcting those deficits (Luauté et al, 2006; Redding and Wallace, 2006; Bowen et al, 2007; Kerkhoff and Schenk, 2012). Unfortunately, success has been limited.…”

Section: Introductionmentioning

confidence: 99%

Statistical Learning as a Tool for Rehabilitation in Spatial Neglect

Shaqiri¹,

Anderson²,

Danckert³

2013

Front. Hum. Neurosci.

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We propose that neglect includes a disorder of representational updating. Representational updating refers to our ability to build mental models and adapt those models to changing experience. This updating ability depends on the processes of priming, working memory, and statistical learning. These processes in turn interact with our capabilities for sustained attention and precise temporal processing. We review evidence showing that all these non-spatial abilities are impaired in neglect, and we discuss how recognition of such deficits can lead to novel approaches for rehabilitating neglect.

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Cognitive rehabilitation for spatial neglect following stroke

Cited by 72 publications

References 27 publications

Treatment of visuospatial neglect with biparietal tDCS and cognitive training: a single-case study

Treatment of visuospatial neglect with biparietal tDCS and cognitive training: a single-case study

Reducing Chronic Visuo-Spatial Neglect Following Right Hemisphere Stroke Through Instrument Playing

Statistical Learning as a Tool for Rehabilitation in Spatial Neglect

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